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General NPI Number Information
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NPI Number | 1316323082
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Entity Type | Organization
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Legal Business Name | LEE, DEAN AND ANGHESOM, PLLC
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Dates
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Enumeration Date | 08/05/2015
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Last Update Date | 08/05/2015
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Provider Practice Location Address
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Address Line | 2425 E HACIENDA AVE
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City | LAS VEGAS
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State | NV
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Zip | 89120-1810
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Country | US
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Telephone | 702-456-7621
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Fax | 702-456-7625
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Provider Business Mailing Address
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Address Line | 2425 E HACIENDA AVE
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City | LAS VEGAS
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State | NV
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Zip | 89120-1810
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Country | US
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Telephone | 702-456-7621
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Fax | 702-456-7625
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. LYNN LEE
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Credential |
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Telephone | 702-456-7621
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State | NV
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